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Annual healthcare bill of €17bn is ‘unsustainable’

At €17billion, Ireland’s annual healthcare spend is unsustainable in the current model and needs to move from a primarily hospital-based episodic treatment 19th century approach to a 21st century focus on prevention and health maintenance, according to Dr Graham Love, a partner in the consulting services practice at Mazars.

Healthcare budgets in developed countries are drowning the public purse, said Love who previously served as chief executive of the Higher Education Authority; the Health Research Board and Molecular Medicine Ireland as well as holding a senior role in Science Foundation Ireland. “Healthcare budgets are climbing at a rate that is already exceeding our capacity to pay for them. In Ireland, if you add our ageing population, the issue is very significant,” he said.

“In ten years there will be more people in the country over the age of 65 than under 14 years of age. There will be one million people over the age of 65 and 100,000 over 80 years of age. As our population ages, people tend to have co-morbidities, several conditions at once over a sustained period of time. These factors should change the way we deliver healthcare,” Love said.

“Whereas our healthcare system was built on a model of where patients either were cured of their conditions or died from them, now people are living with various conditions. This is placing a burden on our healthcare system that is unsustainable,” contended the Mazars partner who sees the Slaintecare implementation plan as a step in the right direction.

One of the other issues he is seeing arise at the moment is the need for more research. “Modern effective healthcare is based on a three-legged stool: care delivery; training and research. Ireland has always been very good at training – we have a workforce of over 100,000 that is in demand everywhere. We are not bad at care delivery once you are inside the system. However, we have traditionally not been so good at research.

‘There is a view that the people delivering the care should be involved in research to keep up to date and that our brightest and best are not just slogging with a clinical load all the time. Just look at the vacancies in consultant appointments for evidence of this,” said Love.

“Research helps retain good people; informs the education and training process and is mentally stimulating, encouraging them to stay Ireland rather than to move abroad. Most importantly, it is now established that people treated in healthcare settings that are research-active have better health outcomes,” he said. `’Ireland is starting to move on this front with clinical research facilities; clinical trials and better population health planning, but more is needed and it needs to be part and parcel of care delivery,” Love contended.

More joined up thinking, he said, is also required on data. “Health policy and decision making need to be built on better evidence. We are not harnessing the potential of the data already in the system. We are not good at aggregating the data and deriving insights from it, the kind of insights that would deliver better value from our €17billion spend.”

Pointing to the use of loyalty cards and purchasing data for customer insights in the retail sector for decades, the Mazars partner said that the healthcare sector is some way behind in using its data effectively for patient benefit, for healthcare worker benefit and for the taxpayer.

This article first appeared in Sunday Business Post on the 7th April 2019.

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